Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication
Diabetic ketoacidosis (DKA) is characterized by elevated anion gap metabolic acidosis, hyperglycemia, and elevated ketones in urine and blood. Hyperglycemia is a key component of DKA; however, a subset of DKA patients can present with near-normal blood glucose, an entity described as “euglycemic DKA...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2016/4275651 |
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| author | Asma Abu-Abed Abdin Muhammad Hamza Muhammad S. Khan Awab Ahmed |
| author_facet | Asma Abu-Abed Abdin Muhammad Hamza Muhammad S. Khan Awab Ahmed |
| author_sort | Asma Abu-Abed Abdin |
| collection | DOAJ |
| description | Diabetic ketoacidosis (DKA) is characterized by elevated anion gap metabolic acidosis, hyperglycemia, and elevated ketones in urine and blood. Hyperglycemia is a key component of DKA; however, a subset of DKA patients can present with near-normal blood glucose, an entity described as “euglycemic DKA.” This rare phenomenon is thought to be due to starvation and food restriction in insulin dependent diabetic patients. Cocaine abuse is considered a trigger for development of DKA. Cocaine also has anorexic effects. We describe an interesting case of euglycemic DKA in a middle-aged diabetic female presenting with elevated anion gap metabolic acidosis, with near-normal blood glucose, in the settings of noncompliance to insulin and cocaine abuse. We have postulated that cocaine abuse was implicated in the pathophysiology of euglycemic DKA in this case. This case highlights complex physiological interplay between type-1 diabetes, noncompliance to insulin, and cocaine abuse leading to DKA, with starvation physiology causing development of euglycemic DKA. |
| format | Article |
| id | doaj-art-7818adfb0f1e4b7f887e8651727e3ab6 |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-7818adfb0f1e4b7f887e8651727e3ab62025-02-03T01:11:37ZengWileyCase Reports in Critical Care2090-64202090-64392016-01-01201610.1155/2016/42756514275651Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine IntoxicationAsma Abu-Abed Abdin0Muhammad Hamza1Muhammad S. Khan2Awab Ahmed3Jordan University for Science and Technology, P.O. Box 3030, Irbid 22110, JordanDepartment of Medicine, Dow Medical College, Baba-E-Urdu Road, Karachi 74200, PakistanSection of Pulmonary & Critical Care Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L Young Boulevard, Oklahoma City, OK 73104, USASection of Pulmonary & Critical Care Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L Young Boulevard, Oklahoma City, OK 73104, USADiabetic ketoacidosis (DKA) is characterized by elevated anion gap metabolic acidosis, hyperglycemia, and elevated ketones in urine and blood. Hyperglycemia is a key component of DKA; however, a subset of DKA patients can present with near-normal blood glucose, an entity described as “euglycemic DKA.” This rare phenomenon is thought to be due to starvation and food restriction in insulin dependent diabetic patients. Cocaine abuse is considered a trigger for development of DKA. Cocaine also has anorexic effects. We describe an interesting case of euglycemic DKA in a middle-aged diabetic female presenting with elevated anion gap metabolic acidosis, with near-normal blood glucose, in the settings of noncompliance to insulin and cocaine abuse. We have postulated that cocaine abuse was implicated in the pathophysiology of euglycemic DKA in this case. This case highlights complex physiological interplay between type-1 diabetes, noncompliance to insulin, and cocaine abuse leading to DKA, with starvation physiology causing development of euglycemic DKA.http://dx.doi.org/10.1155/2016/4275651 |
| spellingShingle | Asma Abu-Abed Abdin Muhammad Hamza Muhammad S. Khan Awab Ahmed Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication Case Reports in Critical Care |
| title | Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication |
| title_full | Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication |
| title_fullStr | Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication |
| title_full_unstemmed | Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication |
| title_short | Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication |
| title_sort | euglycemic diabetic ketoacidosis in a patient with cocaine intoxication |
| url | http://dx.doi.org/10.1155/2016/4275651 |
| work_keys_str_mv | AT asmaabuabedabdin euglycemicdiabeticketoacidosisinapatientwithcocaineintoxication AT muhammadhamza euglycemicdiabeticketoacidosisinapatientwithcocaineintoxication AT muhammadskhan euglycemicdiabeticketoacidosisinapatientwithcocaineintoxication AT awabahmed euglycemicdiabeticketoacidosisinapatientwithcocaineintoxication |